Bench-to-bedside review: The value of cardiac biomarkers in the intensive care patient

The use of cardiac biomarkers in the intensive care setting is gaining increasing popularity. There are several reasons for this increase: there is now the facility for point-of-care biomarker measurement providing a rapid diagnosis; biomarkers can be used as prognostic tools; biomarkers can be used to guide therapy; and, compared with other methods such as echocardiography, the assays are easier and much more affordable. Two important characteristics of the ideal biomarker are disease specificity and a linear relationship between the serum concentration and disease severity. These characteristics are not present, however, in the majority of biomarkers for cardiac dysfunction currently available. Those clinically useful cardiac biomarkers, which naturally received the most attention, such as troponins and B-type natriuretic peptide, are not as specific as was originally thought. In the intensive care setting, it is important for the user to understand the degree of specificity of these biomarkers and that the interpretation of the results should always be guided by other clinical information. The present review summarizes the available biomarkers for different cardiac conditions. Potential biomarkers under evaluation are also briefly discussed

Le Canada et les Roms : gouverner l’inconnaissable

Aux yeux du Conseil de l’Europe et de l’Union européenne, de même que pour plusieurs États européens, le groupe connu sous le nom de « Roms » pose un problème de nature politique : ce groupe remet en question les conceptions d’identité nationale, de lieu, d’appartenance, de territoire, de citoyenneté et de droits. Il est difficile de définir de façon empirique la « communauté » rom, que ce soit relativement à la taille de sa population (entre huit et douze millions), à sa localisation (partou..

Planning systems for small firms.

A study was carried out into the planning practices of four small building firms through interviews and questionnaires. The techniques of systems analysis were used to model the information flows through the firms. These revealed the firms to suffer from problems of integration between planning and other functions. The breakdown of the work for one function often did not suit the purposes of others. Project data often had to be regenerated. The firms did not evaluate their performance systematically in a way that would be of benefit to future contracts.A specification for a new system was developed to eliminate these deficiencies and to take advantage of the power of the microcomputer. The system derived data from the estimate. A work breakdown structure allowed the integration of planning, targeting, progress reporting, reporting of hours, and valuations. The database of estimate operations was maintained through an analysis of timesheets. Information for the scheduling of materials and subcontractors could be derived from the resulting programme.The small firms problem of integrating the demands imposed by a fluctuating workload on a relatively inflexible labour supply was considered. The use of decision rules to resolve conflicts through the levelling of a multiproject schedule was investigated. A large number of rules were developed using a spreadsheet operating in conjunction with a planning package. These were tested on a number of prototype workloads and assessed by various criteria. After further development a consistently good rule was found.This rule, and that encoded within the planning software, were applied to the levelling of the workload of one of the collaborating firms at various stages of progress over a three month period. The new rule continued to perform well. The feasibility of deriving planning data direct from the estimate, and of using timesheet data both to update programmes and to evaluate performance was demonstrated.The firms methods of materials procurement and handling were investigated. It was found that their collection of materials from suppliers was poorly organised

Impacts of neighbourhood planning in England

Prof. Gavin Parker (University of Reading) Dr Matthew Wargent (University of Reading) Dr Kat Salter (University of Birmingham) Dr Mark Dobson (University of Reading) Dr Tessa Lynn (University of Reading) Dr Andy Yuille (Lancaster University) and Navigus Plannin

Le Canada et les Roms : gouverner l’inconnaissable

Aux yeux du Conseil de l’Europe et de l’Union européenne, de même que pour plusieurs États européens, le groupe connu sous le nom de « Roms » pose un problème de nature politique : ce groupe remet en question les conceptions d’identité nationale, de lieu, d’appartenance, de territoire, de citoyenneté et de droits. Il est difficile de définir de façon empirique la « communauté » rom, que ce soit relativement à la taille de sa population (entre huit et douze millions), à sa localisation (partou..

Intentional paediatric poisoning presentations to emergency departments during the COVID-19 pandemic

Objective: To characterise paediatric poisoning presentations to EDs and determine if the advent of the COVID-19 pandemic was associated with increased intentional paediatric poisoning presentations. Methods: We performed a retrospective analysis of paediatric poisoning presentations to three EDs (two regional and one metropolitan). Simple and multiple logistic regression analysis were performed to determine the association between COVID-19 and intentional poisoning events. In addition, we calculated the frequency with which patients reported various psychosocial risk factors as being an implicating factor in engaging in an intentional poisoning event. Results: A total of 860 poisoning events met inclusion criteria during the study period (January 2018–October 2021), with 501 being intentional, and 359 unintentional. There was an increased proportion of intentional poisoning presentations during the COVID-19 pandemic (261 intentional and 218 unintentional in the pre-COVID-19 period vs 241 intentional and 140 unintentional during the COVID-19 period). In addition, we found a statistically significant association between intentional poisoning presentations and an initial COVID-19 lockdown (adjusted odds ratio 26.32, P < 0.05). ‘The COVID-19 lockdown’ or ‘COVID-19’ was reported to be implicating factor for psychological stress in patients who presented with intentional poisonings during the COVID-19 pandemic. Conclusions: Intentional paediatric poisoning presentations increased during the COVID-19 pandemic in our study population. These results may support an emerging body of evidence that the psychological strain of COVID-19 disproportionately impacts adolescent females. © 2023 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine

Towards on-farm pig face recognition using convolutional neural networks

© 2018 Elsevier B.V. Identification of individual livestock such as pigs and cows has become a pressing issue in recent years as intensification practices continue to be adopted and precise objective measurements are required (e.g. weight). Current best practice involves the use of RFID tags which are time-consuming for the farmer and distressing for the animal to fit. To overcome this, non-invasive biometrics are proposed by using the face of the animal. We test this in a farm environment, on 10 individual pigs using three techniques adopted from the human face recognition literature: Fisherfaces, the VGG-Face pre-trained face convolutional neural network (CNN) model and our own CNN model that we train using an artificially augmented data set. Our results show that accurate individual pig recognition is possible with accuracy rates of 96.7% on 1553 images. Class Activated Mapping using Grad-CAM is used to show the regions that our network uses to discriminate between pigs

Monitoring practices of training load and biological maturity in UK soccer academies

Purpose: Overuse injury risk increases during periods of accelerated growth, which can subsequently impact development in academy soccer, suggesting a need to quantify training exposure. Nonprescriptive development scheme legislation could lead to inconsistent approaches to monitoring maturity and training load. Therefore, this study aimed to communicate current practices of UK soccer academies toward biological maturity and training load. Methods: Forty-nine respondents completed an online survey representing support staff from male Premier League academies (n = 38) and female Regional Talent Clubs (n = 11). The survey included 16 questions covering maturity and training-load monitoring. Questions were multiple-choice or unipolar scaled (agreement 0-100) with a magnitude-based decision approach used for interpretation. Results: Injury prevention was deemed highest importance for maturity (83.0 [5.3], mean [SD]) and training-load monitoring (80.0 [2.8]). There were large differences in methods adopted for maturity estimation and moderate differences for training-loadmonitoring between academies. Predictions of maturity were deemed comparatively low in importance for bio-banded (biological classification) training (61.0 [3.3]) and low for bio-banded competition (56.0 [1.8]) across academies. Few respondents reported maturity (42%) and training load (16%) to parent/guardians, and only 9% of medical staff were routinely provided this data. Conclusions: Although consistencies between academies exist, disparities in monitoring approaches are likely reflective of environment-specific resource and logistical constraints. Designating consistent and qualified responsibility to staff will help promote fidelity, feedback, and transparency to advise stakeholders of maturity-load relationships. Practitioners should consider biological categorization to manage load prescription to promote maturity-appropriate dose-responses and to help reduce the risk of noncontact injury

Property rents in medieval English towns: Hull in the fourteenth century

This paper examines whether property rents varied within the medieval town of Hull. Scholars have been deterred from analysing medieval urban rents because of a belief that they were ‘fossilised’ from an early stage in town development, and therefore did not reflect economic forces that guided the later development of towns. Hull rents reported in the 1347 rental had been set only recently, however. Statistical analysis of these rents reveals the economic topography of the town and leads to a reconsideration of its economic development